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Acute Pain Service (APS)

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The Acute Pain Service (APS) is committed to reducing postoperative pain and assisting with the early phases of rehabilitation from orthopedic surgery. APS provides safe and effective pain management for all surgical patients.

The APS consists of a specialized team of clinicians with expertise in postoperative pain control, including anesthesiologists, nurses with specialized training in pain management, and pharmacists. These physicians are all members of our Critical Care Team. Depending on your medical history and specific case, physicians from the Pain Management Division may be consulted as well.

APS provides state-of-the-art postoperative pain control both regarding analgesic medications and in the techniques used to administer them. An anesthesiologist and a nurse from APS visit each patient on the service once or twice per day. If questions, concerns, or problems arise, a physician from the team is in-house 24 hours a day, seven days a week.

Comprehensive Pain Management

APS uses a multimodal approach to control postoperative pain. This means that several different types of pain medications are used to help reduce pain in different ways. This approach to pain management helps limit the side effects of high doses of one pain reliever while reaping the benefits of pain relief from a different, complementary technique.

Many of our patients will be able to use an analgesic technique called patient-controlled analgesia (PCA). This method allows you to customize the delivery of your pain medication whether by intravenous, epidural, or continuous nerve block routes. You can give themselves additional small doses of pain medication on an as-needed basis. This flexibility allows the APS to address patients' individualized needs.

The APS sets limits and controls to help avoid side effects from pain medications. Extra doses can be given to control pain during peaks of discomfort which may occur during physical therapy. This method of pain management has been associated with higher levels of patient satisfaction, better pain control, and fewer side effects. Nonetheless, you may still experience side effects including nausea, itching, sleepiness, and numbness.

Patients are transitioned to oral pain medications, usually beginning on the first or second day after surgery, in anticipation of discharge.

Opioid Sparing Approaches to Postoperative Pain

Prescription pain medication, most commonly known as opioids, used to treat pain may have side effects ranging from nausea and vomiting to addiction. While there is a need for some opioids in many orthopedic cases, it is not the only pain control method your anesthesiologist uses to manage postoperative pain. In many cases, your anesthesiologist and APS will try to decrease the need for opioids during your recovery.

Epidural analgesia, nerve blocks, continuous nerve blocks, local anesthetics, and ice therapy are just a few non-opioid approaches to pain control for patients following orthopedic surgery. Other opioid sparing approaches to pain management include anti-inflammatory drugs, anti-seizure medications and muscle relaxers that are used in tandem with other methods to help reduce pain after surgery. The use of alternative therapies, such as deep breathing exercises, may be incorporated into your treatment as well.